We’ve all seen them: bulging, ugly veins popping out on the side of an otherwise healthy leg.

But what are varicose veins really?

Dr. Charles Dietzek, founder of the Vein and Vascular Institute and Chief of Vascular Surgery at Kennedy Health System, said varicose veins are abnormal veins that are bulging through the skin, typically due to an underlying, venous insufficiency.

“Your veins have valves inside,” he explained. “The valves open and close to let blood go up against gravity. If you have leaky valves the blood goes in an abnormal pathway.”

Dietzek used Interstate Route 295 as an example of how the venial system works.

“Imagine a road like 295 with all the off ramps,” he said. “What’s supposed to happen is, using the off ramps, the traffic goes onto the highway. They keep it moving in the right direction. Now imagine if those off ramps were closed.”

When the valves — or off ramps — don’t work correctly, the veins become enlarged, bulge out of the skin and cause what are known as varicose veins.

However, the problem lies about a half-inch below the surface in the superficial vein that can’t be seen.

“That vein underneath is allowing the blood to go in the wrong direction,” Dietzek said.

Many patients who suffer from varicose veins — which can cause aching, tiredness, itching, burning, cramping and restless leg syndrome — don’t seek treatment because older practices were painful. A doctor would make two incisions and pull out the affected vein.

Dietzek said today’s treatment is painless and takes about 20 minutes in his office.

“When patients come in with bulging veins, first I check the veins under the skin with ultrasound,” Dietzek said.

During this sort of ultrasound, the patient stands and the doctor looks for which way the blood is flowing.

“I use the ultrasound to find the vein that isn’t working, put a needle into the vein, thread a catheter into the vein — it looks like spaghetti — it heats up and seals the vein shut,” he explained. “Twenty minutes later, the procedure is done. I wrap it in an Ace wrap and compression stocking and the patient can drive home or back to work.”

In an effort to get the word out about this much easier, more comfortable treatment for varicose veins, Dietzek has teamed up with several vascular societies and national spokesperson, Olympic swimmer Summer Sanders, for the Rethink Varicose Veins campaign.

“There are 30 million people that have venous diseases which are five times more common than arterial problems,” Dietzek said. “Because arterial problems can be more serious, we hear more about those.”

Because patients aren’t aware of the dangers of venous diseases and continue to believe the treatment is more uncomfortable than the problem, only approximately 1.9 million of the 30 million afflicted receive treatment each year.